The research proposed here will show the feasibility of an electronic method to measure and report hand hygiene compliance, called Monitor for Hand Hygiene on Patient Contact (MHHPC). MHHPC will determine, record and report whether anyone touching a hospital patient washed or sanitized their hands before or after doing so. This topic is important because hand hygiene is the most cost effective means of preventing hospital-acquired infections, which cost about $40 billion and cause about 99,000 deaths in the US each year. Merely increasing adherence to currently recommended practices, such as hand hygiene, can result in a dramatic reduction in those costs. It is essential to measure a hospital<s hand hygiene rate objectively, reliably and repeatedly, both to determine if an intervention to increase hand hygiene is warranted and to have an objective means of knowing if such an intervention is having the desired effect. MHHPC will achieve those goals. MHHPC will not require anyone to wear an identifying badge, nor will it require human observers. Rather, it will detect hand hygiene, door passage and the presence of a person near the hospital bed electronically, and combine those detections to infer hand hygiene before and after patient contact. Since it is electronic it will not be biased by the Hawthorne effect, as are reports by human observers. Since it is badgeless it will not invade healthcare workers<privacy and will measure hand hygiene by healthcare workers, hospital staff and visitors alike. To demonstrate feasibility in Phase I we will show that, in hospital tests with one health care worker and one patient in the room, MHHPC detects hand hygiene before and after patient contact with negligibly small false alarm and false dismissal rates. In Phase II we will investigate patient-worn devices that detect the presence of another person nearby, so that the patient need not be in bed for MHHPC to detect patient contact. We will remove the Phase I restriction on number of patients and healthcare workers in the room. We will extend MHHPC's capabilities to separately report hand hygiene before and after both clean and dirty patient contact. In Phase III we will negotiate a teaming arrangement with GOJO Industries to commercialize MHHPC. We attach a letter from Shawn Warthman, Head of Compliance at GOJO, in which he states GOJO<s interest in those discussions. PUBLIC HEALTH RELEVANCE: Electronic Measurement of Hand Hygiene on Opportunity will enable health care and other facilities to measure their hand hygiene rates on opportunity such as patient contact, rather than on average or at selected times of day. It will do so objectively, repeatedly and reliably. As a result, Infection Control Practitioners will be able to compare their hospital's hand hygiene rates to those of other hospitals and to national standards, and to evaluate an intervention's value in real time. These advantages will potentially leading to significant savings in dollars and human lives.